Provider Demographics
NPI:1689700130
Name:WOLFER, LINDSEY P (DDS)
Entity Type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:P
Last Name:WOLFER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 TABLE LN
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-3910
Mailing Address - Country:US
Mailing Address - Phone:516-796-4747
Mailing Address - Fax:516-796-9546
Practice Address - Street 1:16 TABLE LN
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-3910
Practice Address - Country:US
Practice Address - Phone:516-796-4747
Practice Address - Fax:516-796-9546
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0337711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice